Total elbow arthroplasty due to injuries

The aim of the study was to identify the features of total elbow arthroplasty in traumatic cases and their consequences in patients of different age groups and to conduct a comparative retrospective analysis of differentiated treatment tactics. Materials and Methods A retrospective analysis of the results of total elbow arthroplasty (TEА) in the period from 2009 to 2019 was carried out in 101 patients with injuries and severe consequences of elbow joint injuries, 56 (55.4 %) men and 45 (44.5 %) women among them in the average age of 48.5 ± 12.5 years. Three groups of patients were formed. Group I were 29 (28.7 %) subjects who underwent conservative treatment of fractures before TEА; the second group (II) of 52 (51.5 %) patients underwent TEА after ORIF, the third group of 20 (19.8) individuals (III) were patients who had primary TEА. We investigated pain (VAS), range of motion, tests with the DASH and MEPS scales, hand strength. Results One year later, there was a statistical difference in the results (p = 0.0213) between group III DASH = 7.3 ± 2.1) compared with groups I (DASH = 20.6 ± 3.3) and II (DASH = 18.4 ± 4.2); in group III, MEPS was excellent (90.7 ± 8.4), and in groups I (MEPS = 83.8 ± 7.4) and II (MEPS = 84.2 ± 5.6) good (p = 0. 0344). There were no differences in the dynamometry of hand strength and pain. Discussion Treatment of fractures of the elbow joint is a challenge that has several aspects. Conservative treatment results in high incidence of pronounced contractures, which affect the range of motion in the elbow joint after TEA; in severe damage to bone and cartilage, it is necessary to evaluate many factors in order to make the right choice between ORIF and primary TEА. New prosthetic technologies are needed to ensure good long-term functioning of the elbow prosthesis, especially in young patients. Conclusion To choose the treatment tactics in severe injuries of the elbow joint, it is necessary to consider not only the severity of the injury, but also the age of the patient and the quality of the bone, especially in elderly patients. Rejection to perform osteosynthesis in favor of primary total arthroplasty is aimed at maintaining the range of motion, improving the functional results and survival of the endoprosthesis.